plateau — 21 things I got wrong before I got it right
plateau — 21 things I got wrong before I got it right. It is the sort of thing everyone half-believes and nobody writes down.
Week 54: 15kg down, early fullness basically gone since about week 8, and the honest headline is that nothing dramatic happened. It was boring and it worked.
Weight change and appetite change are different endpoints on different timescales. Conflating them is where most of the confusion on this board starts.
STEP-1 ran 68 weeks and landed just under 15% mean body weight change on 2.4mg. It is an average of a wide distribution, not a target you have missed.
Please do not ask me what dose you should be on. I genuinely do not know and neither does anyone else here.
best — the order this archive was captured in
The escalation schedule in the trials existed to keep people on the drug. It is a tolerability ramp, and it is why the label reads the way it does.
The escalation schedule in the trials existed to keep people on the drug.
sorted_by_new is describing the standard shape here and it matches the trial data better than most anecdotes do.
staying at 0.25mg for an extra month is a legitimate plan
dose day drift of a day either way is fine, the curve barely notices
if 0.5mg is working there is no prize for going up
the appetite signal and the scale move on different clocks
stalling at 2.4mg is information, not a verdict
Steady state after a dose change takes four to five half-lives, so the fair judgement point on a new step is about a month, not four days.
nausea that arrives on day two and fades by day four is the standard shape
nausea that arrives on day two and fades by day four is the standard shape
Adding one thing to this: the appetite effect and the scale run on separate clocks, so both halves can be true at once.
Steady state after a dose change takes four to five half-lives, so the fair judgement point on a new step is about a month, not four days.
Disagree with this specific line. A pause at 1.0mg is not evidence that 1.0mg has stopped working.
The weekly interval comes out of the half-life — roughly a week — so you are on a smooth curve rather than a series of spikes. That is also why moving your day slightly does very little.
do not chase somebody else’s titration schedule, they are not you
Cosigning. The appetite change and the scale change ran about three weeks apart for me too.
First month I lost almost nothing and nearly quit. Month two and three were where it all happened.
Standard reminder: no personal titration plans for other members, and no medical advice. Everything else is fine.
Sceptical of the mechanism you are proposing. Gastric emptying slows, it does not stop, and the timings you describe do not follow from it.
- 1Steady state after a dose change takes four to five half-lives, so the fair…9 comments in this branch · started by u/zeynep_zielinski